Secret Shopper Survey Finds Therapists Listed in Insurer Networks Are Often Phantoms

A new study brings alarming clarity to a problem thousands of people complain about: that they can’t find a therapist when they need one – even though they have health insurance and the on-line directories of their insurance companies claim to have plenty of available clinicians.

Trained callers working with a team of Ohio State University researchers combed through those directories and made calls posing as relatives of people seeking appointments for non-emergency mental health conditions.

More than three-quarters of their attempts to schedule appointments failed – because phone numbers were out of order, calls went unanswered or clinicians were unavailable. In the end, only about 12% of more than 5,800 calls to psychiatrists and psychologists listed in the online directories of major commercial insurers in five states resulted in an appointment with a clinician. The results of the study were published in the JAMA Health Forum.

“The big takeaway is that coverage does not equal access,” said Simon F. Haeder, the study’s lead author, in an email. “We looked at the largest, most resourced, and probably most reputable carriers in these states. Other carriers are likely worse.”

People who get their insurance from Medicaid or Affordable Care Act marketplaces may have an especially difficult time finding a clinician to care for them, Haeder says.

“When people can’t find in-network care, they pay out of pocket, go out of network, or give up,” he said. “That raises real questions about disparities.”

The research callers used the “secret shopper method” to examine the largest insurance directories in Delaware, Montana, New Jersey, Rhode Island and Virginia between October 2025 and March 2026. Nearly two-thirds of the calls produced no clear outcome, or couldn’t be evaluated – largely because callers reached an answering machine or automated phone system without an option to speak to staff. Researchers excluded those calls from their analysis.

The study highlights the problem of so-called “ghost networks” – insurance directories that list providers who are unreachable or no longer accepting certain plans, leaving people who need mental health care in a lurch.

Federal rules under the No Surprises Act require insurers to verify and update provider directory information at least every 90 days. But the persistence of inaccurate listings suggests those requirements may lack teeth, the researchers wrote.

Less than a quarter of evaluable calls resulted in a scheduled appointment with the listed clinician. The success rate was slightly higher when the office offered alternative clinicians. Even after securing appointments, patients faced additional delays, averaging three weeks, with longer waits for psychiatry appointments than for psychology appointments.

The researchers recommended stronger oversight of directory accuracy and evaluating insurance networks based on patients’ actual experiences, whether they can reach clinicians, make appointments, and receive timely care — rather than relying solely on the number of providers listed.

“Regulators should be less trusting and worry more about enforcement and verification,” Haeder said. “We need to have real conversations about what type of care people should have access to and what is expected of carriers and providers. Patient experiences should matter more.”